Each academic year the Rheumatology Fellowship Program matriculates three or four rheumatology fellows who will complete two years of subspecialty training. Following these two years, Fellows will have fulfilled the American Board of Medical Examiners requirements to be Board Eligible and sit for the Rheumatology Board examination. The first year of training is clinical and Fellows participate in three continuity care clinics. These clinics include the NIAMS Community Health Clinic, the NIAMS Clinical Center Arthritis Clinic, and the NIAMS Clinical Center Pediatric Rheumatology Clinic. In addition to these clinics, other patient care activities include the NIAMS inpatient ward, and the inpatient and outpatient consultative services. First year Fellows spend one month participating in an in-patient consultation rotation. All Fellows participate in core curriculum lectures that provide didactics concerning general rheumatology during the first five weeks of training. Additional teaching sessions include weekly core lectures, business meetings, clinical journal clubs, Rheumatology Grand Rounds, and a weekly translational journal club. Other core conferences include Director's Rounds, Intra-City Grand Rounds, clinical evening journal clubs and the District of Columbia Rheumatism Society meetings. Attendance is required of all trainees to NIH sponsored events to fulfill the requirements for training. During the first year, all Fellows are encouraged to discuss research activities with Faculty such that in the second year they can begin a mentored research activity. During the second year of Fellowship, ACGME guidelines mandate a continuity care clinic and didactic activities. This leaves approximately 80% protected time for the Fellow to gain a meaningful research exposure. The research is encouraged to be either basic bench science or clinical research. Recent examples of research projects include the study of heritary forms of inclusion body myositis, the study of inflammatory bowel disease is a novel transgenic mouse, and the examination of immunoglobulin gene regulation. The Clinical Fellowship program is vital to clinical research at the Clinical Center because all Fellows provide care for patients that are enrolled in the following protocols: 98-HG-0124 Genetics of Rheumatoid Arthritis: The North American Rheumatoid Arthritis Consortium 94-HG-0105 Genetics and Pathophysiology of Familial Mediterranean Fever and Related Disorders 04-AR-0066 Studies of the Pathogenesis and Natural History of Systemic Lupus Erythematosus (SLE) 08-AR-0008 Insulin Resistance and Atherosclerosis in a Sample of Women with Systemic Lupus Erythematosus 00-AR-0222 Studies of the Pathogenesis and Natural History of Arthritis and Related Conditions 03-AR-0173 Studies of the Natural History and Pathogenesis of Neonatal Onset Multisystem Inflammatory Disease (NOMID) 01-AR-0227 Natural History of Rheumatic Disease in Minority Communities 02-AR-0156 A Randomized, Double-Blind, Placebo-Controlled Trial of Infliximab In Patients With Dermatomyositis and Polymyositis 03-AR-0133 Clinically Important Changes in Rheumatoid Arthritis 07-E-0012 Rituximab in the Treatment of Refractory Adult and Juvenile Dermatomyositis (DM) and Adult Polymyositis (PM) 91-AR-0196 Studies on the Natural History and Pathogenesis of Polymyositis, Dermatomyositis, and Related Diseases 99-D-0070 Natural History of Salivary Gland Dysfunction and Sjogren's Syndrome 99-AR-0004 Molecular Basis of Primary Immunodeficiencies 08-AR-0218 Rilonacept to Treat Familial Mediterranean Fever 09-AR-0066 Canakinumab to Treat Neonatal Onset Multisystem Inflammatory Disease